Surgical instrument

ABSTRACT

The invention relates to a surgical instrument primarily for use during the sterilization of females. The instrument has a handle, a shank and a curved or hook-shaped primary portion. The primary portion is capable of insertion into the uterus where it engages the inner surface of the posterior uterine wall so that, when the instrument is rotated through an angle of approximately 180* the fundus of the uterus is pressed downward in acute retroversion into the cul-de-sac of the peritoneal cavity.

United States Patent 1191 111.1 3,809,091 Shute [451 May 7, 1974SURGICAL INSTRUMENT 2,296,793 9 1942 Kirschbaum 123/20 [76] Inventor:Wallace B. Shute, 300 Island Park Dr., Ottawa, Ontario, Canada [22]Filed: July 31, 1972 [21] App]. No.: 276,313

[30] Foreign Application Priority Data Aug. 25, 1971 Canada 121340 [52]us. c1. 128/303, 128/361 [51] Int. Cl A61b 17/42 [58] Field of Search128/303 R, 361, 20, 2 R

[56] References Cited UNITED STATES PATENTS 1,144,220 6/1915 Maguire128/2 R-X 4/1929 Hyde 128/20 The invention relates to a surgicalinstrument primar- Primary Examiner-Lucie l-l. Laudenslager Attorney,Agent, or Firm-Cushman, Darby & Cushman ABSTRACT ily for use during thesterilization of females. The instrument has a handle, a shank and acurved or hookshaped primary portion. The primary portion is capable ofinsertion into the uterus where it engages the inner surface of theposterior uterine wall so that, when the instrument is rotated throughan angle of approximately 180 the fundus of the uterus is presseddownward in acute retroversion into the cul-de-sac of the peritonealcavity.

' 5 Claims, 6 Drawing Figures SURGICAL INSTRUMENT This invention relatesto surgical instruments and more particularly to an instrument usedduring sterilization of females. r

As is well known, sterilization of females is best effected by removinga section of each Fallopian tube. In order to obtain access to thesetubes, a posterior colpotomy incision is made in the vaginal vaultimmediately behind the uterus, opening into the cul-de-sac of theperitoneal cavity to expose the tubes. Before the 'tubes can be reachedhowever, the usually anteverted uterus must be acutely 'retroverted tobring its fundus its attached Fallopian tube (also not shown). I-Iereand tubes within direct range of the operator working through thatcolpotomy incision. It is the object of this inventionto provide asimple and relatively inexpensive instrument for so retroverting theuterus, in a quick and simple manner without damage to the soft uterinetissue, thus exposing the Fallopian tubes without recourse toabdominalincision.

The invention is illustrated, by wayof example, inthe accompanyingdrawings in which:

FIG. 1 is a perspective view of the surgical instrument;

FIG. 2 is a diagrammatic view of the instrument in situ within thevagina and uterus, when the latter is in its normalposition;

FIG. 3 is a view similar to FIG. 2 but showing the instrument in situafterretro-displacement of the uterus;

FIG. 4 is a diagrammatic section taken through the uterus; and I moves asection of the tube, then returns said ovary and its tube through theincision. The uterus is then deflected in the opposite direction and thesecond ovary and tube is similarly located and treatedrThe saidinstrument in the uterine cavity is thenfrotated through an angle ofapproximately 180 to restore the uterus to its normal position and theposterior colpotomy incision I closed by suture.

If desired, the distal end of the primary portion 1 of the instrumentand the surface 4 formed by the smallerradius may beknurled as at 5 inFIG. 5 or provided with grooves as is indicated at 6 in FIGS. 1-3 and 6.By proa viding such an irregular surface at these locations conavoidingall slippage.

,FIGS. 5 and 6 are in detail views of the distalend of I the primaryportion of the instrument, on anenlarged scale showing alternativeembodiments of surface finlshs Referring to the drawings, and inparticular to FIG. 1, itwill'be seen that thesurgical instrument,includes a curved primary portion 1, which is capable of insertion intothe uterus, a shank 2 secured to the proximal end of the primaryportion, and a handle 3 secured substantially at right. angles to theterminal end of the shank remote from the portion 1. The distal end ofthe primary portion 1 is rounded and, in cross-section, said portion andthe shank 2 are each substantially circular.

In use, and reference should now be made to FIG. 2, the instrument isinserted into the vagina, indicated generally at V, so thatthe primaryportion 1 is located in the uterusU. Itwill be seen from FIGS. 2 and 4,that the curve of the primary portion 1 approximates to the curve of thecentral vertical axis A-A of the uterus.

Prior to theinsertion of theinstrument, a posterior colpotomy incision Iis made in the vaginal vault immediately behind the uterus.

When the instrument is in situ, the surgeon grasps the handle 3 andturns the instrument through an angle of approximatelyl80. During suchrotation, the primary portion 1 of the instrument engages the innersurface of the posterior wall of the uterus and the fundus of the stantpressure between the instrument and the inner surface of the wall of theuterus is-maintained thus In addition, it will be noted from FIGS. 1-3that the shaft is preferably provided with a pair of opposed flatsurfaces 7 which enable the surgeon to obtain better purchase. I

I claim; r

.1. A surgical instrument capable of mechanically retroverting theuterus andholding itin that desired posi-,

tion for operative intervention including sterilization;

said instrument including g a aprimary portion curved to approximate tothe curveof the centralvertical axis of the uterus and having apredetermined irregular surface area for engaging the inner surface ofthe posterior uterine wall, the crosssection of said portion beingsubstantially circular with a substantially constant diameter throughoutits length and having a rounded end capable of automatically pressingthe fundus of the uterus downward in acute retroversion into thecul-de-sac of the peritoneal cavity;

b a shank, substantially circular in cross-section, secured to theproximal end of said portion; and

c a handle, secured substantially'at right angles to the terminal end ofsaid shank remote from said portion, for rotating the instrument throughan angle of substantially after insertion of the instrument into theuterus.

2. An instrument according to claim 1 wherein said 4. An instrumentaccording to claim 2 including a pair of opposed flattened surfaces onsaid shank.

5. An instrument according to claim 3 including a pair ofopposedflattened surfaces on said shank.

1. A surgical instrument capable of mechanically retroverting the uterusand holding it in that desired position for operative interventionincluding sterilization; said instrument including a a primary portioncurved to approximate to the curve of the central vertical axis of theuterus and having a predetermined irregular surface area for engagingthe inner surface of the posterior uterine wall, the cross-section ofsaid portion being substantially circular with a substantially constantdiameter throughout its length and having a rounded end capable ofautomatically pressing the fundus of the uterus downward in acuteretroversion into the cul-de-sac of the peritoneal cavity; b a shank,substantially circular in cross-section, secured to the proximal end ofsaid portion; and c a handle, secured substantially at right angles tothe terminal end of said shank remote from said portion, for rotatingthe instrument through an angle of substantially 180* after insertion ofthe instrument into the uterus.
 2. An instrument according to claim 1wherein said irregular surface area is formed by knurling.
 3. Aninstrument according to claim 1 wherein said irregular surface area isformed by grooving.
 4. An instrument according to claim 2 including apair of opposed flattened surfaces on said shank.
 5. An instrumentaccording to claim 3 including a pair of opposed flattened surfaces onsaid shank.